Sarah Galvani

Motivational Interviewing: Helping People Change (3rd edition)

Motivational Interviewing (MI) is still a relatively recent approach. It first emerged in the early 1980s as a result of Miller’s reflections on how to improve his clinical psychology practice. However, the first edition of the text book was not published until 1992. Since then the popularity of MI has burgeoned, as has the evidence for its effectiveness in a range of workplace contexts. For those unfamiliar with MI, the authors describe it as a ‘collaborative communication style’. They state MI practitioners ‘guide’ conversations rather than ‘direct’ them or simply react or ‘follow’. In other words, MI does not tell people what to do (directing), nor does it just mean good listening (following); the authors describe it as the ‘middle ground’ between the two requiring a practitioner who is a good listener but can also offer expertise where and when appropriate. MI offers:

Responsible disinhibition: Alcohol, men and violence to women

Theories about alcohols role in stranger violence abound. Theories about alcohols role in ‘domestic violence’1 do not. The targets of such violence differ as does the nature of the violence towards them. Theory needs to reflect this. This article reviews key theories linking alcohol and violence. Further, it reports on research with 20 women that resulted in an alternative theory on the role of alcohol in their partners violence. The results of the research are summarised and placed within the theoretical model, ‘Responsible Disinhibition’. The model is grounded in the womens views and highlights individual responsibility for violence regardless of the level of intoxication. Finally, this article argues that theory needs to reflect the socio-cultural context in which it was constructed – a context that combines two culturally male and culturally tolerated behaviours – heavy drinking and violent behaviour.

Alcohol and Domestic Violence Womens Views

Alcohol’s role in men’s violence to women is a controversial issue. In the United Kingdom, little research has been conducted on the link between the two, and no in-depth studies have sought the views of the women who suffer such violence. This article reports on in-depth research with 20 women that aimed to hear their views on the role of alcohol in men’s violence to them. The results of the research show that women do not blame alcohol for their partner’s violence; they hold the men, not their alcohol consumption, responsible for their actions.

How Well Prepared are Newly Qualified Social Workers for Working with Substance Use Issues? Findings from a National Survey in England

There is limited research in the United Kingdom on how well prepared social workers are for working with substance use issues. This study set out to explore the views of newly qualified social workers on the extent to which their qualifying programme prepared them for practice with people using alcohol or drugs. It also sought to identify their future training needs and identify examples of good practice among qualifying programmes. A self-completion questionnaire was developed and disseminated via email to 2,914 newly qualified social workers in England; 284 questionnaires were returned. Findings suggested that most respondents considered themselves inadequately prepared for working with substance use and misuse issues. They reported having very little input during qualifying education and identified a range of future training needs. Few examples of good practice were identified. In light of these findings, social work academics and employers need to recognise this serious gap in knowledge and act quickly to ensure social workers are able to meet their service users’ needs confidently and competently.

Refusing to Listen: Are We Failing the Needs of People with Alcohol and Drug Problems?

This paper argues that social work education in the UK has persistently failed to equip its social workers with the knowledge to work effectively with people with alcohol and drug problems. In spite of continuing criticism of the professions unwillingness or inability to engage with substance use issues, social work education has failed to respond to the calls for better training on this subject, even when specific guidance has been issued about course content. This results in a failure to meet the needs of our service users as well as social work staff who remain frustrated at their inability to intervene. The paper explores the historical and current debate about social work training in relation to alcohol and drugs and identifies the barriers to its inclusion in qualifying and post‐qualifying (PQ) curricula. Finally it offers a strategy for improving social work training as well as an overview of programme content requirements.

Safety in numbers? Tackling domestic abuse in couples and network therapies.

Family, network or couples-based therapies have been helping to support people with substance problems for decades. Their value in supporting a person to change their alcohol or drug use is clear. However, as links between substance use and domestic abuse are increasingly recognised, these approaches need to reflect on the potential safety risks they present to people taking part. The prevalence of domestic abuse among people receiving drug and alcohol services is considerably higher than general population estimates, yet this does not appear to have been adequately addressed in network therapies. This article suggests that this needs to change and that safety of service users needs to be at least as important as the intervention itself. It offers for debate a number of potential safety issues raised by network therapies where there is evidence of domestic abuse; it provides examples of three approaches used to marshal social and network support in substance interventions; and offers a number of suggestions for how network therapies can ensure their use remains safe and supportive where there is domestic abuse.

Working with substance use: Levels and predictors of positive therapeutic attitudes across social care practitioners in England

Aims: To measure the attitudes of social care practitioners towards working with alcohol and other drug (AOD) use and to identify the factors which can be used to predict positive engagement. Methods: A cross-sectional online survey was completed by 646 front-line social care practitioners in 11 English Local Authorities. The survey included an adapted version of the Alcohol and Alcohol Problems Perceptions Questionnaire to measure overall therapeutic attitudes (OTAs). Using a principle component analysis, four attitudinal components were identified within the tool; role adequacy, role support, role legitimacy and role engagement. Findings: Analysis of 597 responses (sub-sample excluding specialists substance misuse workers) revealed an average OTA score of 4.68 (SD = 0.662; range: 1–7). The majority of scores (69%) fell in the middle range indicating that practitioners were neither positively nor negatively engaged with AOD-related work. Respondents reported more positive perceptions of role support and legitimacy (56% and 54%, respectively) than for role adequacy and role engagement (25% and 20%, respectively). A multiple regression model revealed that perceived preparedness by qualifying training, employing directorate, AOD-related practice experience and gender, were all predictors of OTAs. Conclusion: For these social care professionals, neither positive nor negative attitudes towards working with AOD dominated. However, this research identifies several factors important for converting the largely ambivalent attitudes of social care practitioners into positive engagement with AOD use.

Supporting people with alcohol and drug problems : making a difference

Setting the scene: alcohol and drugs in social work practice Working with people using substances Working with specialist substance use services Substance use among Black and minority ethnic people Substance use and parenting Domestic abuse and substance use Older peoples substance use Young peoples substance use Co-existing mental distress and substance use Mind the gap: people with disabilities and substance use Conclusion.

SCARS: A New Model for Social Work with Substance Users

A high proportion of social work clients have problems with alcohol or drug use, yet the majority of social work students entering the profession have little, if any, training on this topic. The qualified social worker fares little better. Not surprisingly, both student and worker report feeling ill-equipped to work with clients who have problems with substance use. This paper offers two models that social workers can use when working with clients needing help for substance problems. It briefly presents DECLARE, a step-by-step model for making appropriate referrals for clients with substance problems. It then explores, in greater depth, the Six Cornered Addiction Rescue System (SCARS). SCARS provides an analytical framework that allows social workers to assess quickly what client resources need to be in place to optimise their chances of success in addictions treatment. Further, it fits well with existing social work theory, as well as models and principles of social work practice.

Working with Older People with Alcohol Problems: Insight from Specialist Substance Misuse Professionals and their Service Users

Significant numbers of older people worldwide have a drinking level or pattern which places them at risk of harm. In England, older people are more likely to be admitted to hospital for an alcohol-related condition than younger people and levels of alcohol-related harm are increasing fastest in this population. Whilst alcohol problems in older people are highly treatable, they frequently go undetected or ignored. The aim of this study was to develop guidelines for health and social care workers on what intervention strategies are likely to work best with older drinkers. Insight from alcohol practitioners who specialise in working with older people and the perspectives of older people receiving alcohol treatment were gained through focus groups and individual interviews. This paper reports some of the key findings including a perception that health and social care workers often did not intervene when alcohol misuse was suspected because of ageist attitudes and false beliefs about older peoples drinking. Participants however acknowledged that social workers faced difficult choices in relation to the ‘right’ of older people with alcohol problems to continue to drink and the ‘risk’ associated with them doing so. The implications for social work education and training are discussed.